Nurse Well-Being in the Face of an Ongoing Pandemic

Nurse Well-Being in the Face of an Ongoing Pandemic

November 18, 2021
November 18, 2021

What matters? After innumerable months in a pandemic, it's a question that individuals, families, and businesses circle back to continuously. Health and well-being rise up as answers. Yet, nurses—those people who help us stay healthy—are struggling to do their jobs, struggling to find the mental and physical stamina to serve. Nurses of all types are crucial to healthcare. Yet, the COVID-19 pandemic has stretched nurses' ability to assist patients and deliver care. 

Between August and September 2021, a total of 10,022 nurses responded to the Nursing Professionals Pulse Survey, administered through the NurseGrid, the number 1 rated app for nurses. This survey – as a follow-up to previous surveys tracking the impact of COVID-19 on nurses – asked respondents to rate various aspects: well-being, concerns for the future, career satisfaction, and the toll the pandemic has on themselves and their colleagues. The survey results were analyzed by HealthStream, NurseGrid's parent company. 

Nurses are distressed

The results show a worsening of morale, staffing, and resources compared to data from the January 2021 pulse survey. Almost all nurses surveyed (91.5%) are highly concerned about the nursing shortage, and a majority of nurses (76.7%) report working more shifts or hours than they did a year ago.

Nurses feel the burden of delivering the best possible patient care but face the reality of being only one person trying to help many. "The more patients any nurse has, the more the ability to care for each of them will be compromised," writes nurse Theresa Brown1. When asked to identify reasons why they may be prevented from delivering quality care to patients, 77.2% of survey respondents said they are experiencing high levels of burnout and mental health issues. The World Health Organization describes burnout as an "occupational phenomenon" – not a medical condition – resulting from chronic workplace stress that has not been successfully managed2.

"An astounding number of respondents, 33.6% of nurses, said they are altering their career plans at the end of 2021, with early-career nurses more likely to leave the profession compared to their peers,” said Scott McQuigg, senior vice president and general manager at HealthStream. "However, nurses who work in healthcare facilities where their employer has implemented new well-being initiatives had higher levels of career fulfillment."

Generational differences span well-being and career fulfillment

One of the top three issues of concern for nurses surveyed is "the well-being of my colleagues" (87.6%). Dealing with physical, mental, and emotional fatigue, nurses pay attention to the health of those around them. Asked about their well-being, reactions differed across age groups. Nurses between 18-24 years are least likely to give a high rating to their overall well-being; however, the percentage increases steadily as age increases. For example, while 17.2% of the youngest nurses rate their well-being as high (a rating of 8-10), nurses in the 55-64 age range (47.5%) and 65+ range (47.4%) have a much higher assessment of their well-being.

When asked to rate career fulfillment, scores followed a similar trajectory – more negative ratings among younger nurses (fewer than 20% of them choosing a rating of 8-10) compared to those age 45+ (over 35% gave a high fulfillment score). This generational difference may be linked to years of experience in ones' career. Stepping out of nursing school and into the workforce is a transition, and situational conditions like workplace culture, stress, and the ongoing pandemic may alter career satisfaction. This same younger group is also more likely to say that there is a shortage of nurses, with over 94% marking this a key concern.

Nurse retention and care starts with employers

Healthcare leaders can do more to show nurses that they are "seen" and valuable. The Nurse Pulse survey results reveal that nurses had higher well-being scores in organizations where employers have implemented new initiatives over the past 18 months. The mean career fulfillment scores on a scale of 1 (low) to 10 (high) show:

  • 6.36 – Organizations where the employer HAS implemented new initiatives
  • 5.84 – Organizations where the employer HAS NOT implemented new initiatives

Among employers who have taken action, the most common activities have been offering counseling services to help cope with burnout and mental health issues (31.5%) and hiring more staff (27.7%).

The U.S. Bureau of Labor Statistics estimates a 9% growth in employment of registered nurses for 2020-2030, with 194,500 openings3 projected each year, on average, over the decade. As older nurses retire and the U.S. population ages, there is increased demand for healthcare workers. Care facilities will need to hire and retain nurses to sustain the nation's healthcare delivery system.

Promoting self-care actions like taking time off, talking with colleagues or a counselor, and exercising are beneficial for well-being and resiliency. In addition, once the pandemic subsides, facilities that show the most improvement in their nurse engagement scores will likely retain more staff and have a better chance at providing adequate staffing levels.

Read the full survey report, Nurse Well-Being in the Face of an Ongoing Pandemic



1 – New York Times Opinion piece, Covid-19 Is 'Probably Going to End My Career,' by Theresa Brown,

2 – The World Health Organization,

3 – U.S. Bureau of Labor Statistics, Employment Projections program, data updated September 8, 2021,